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Themed Short Track - November/December 2018
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Introducing Themed Short Tracks

In SHORT TRACKS we collect 2-4 recent lectures from EAS congresses or courses, putting them together to provide up-to-date perspectives on a given current topic.

This month’s SHORT TRACK topic is Lipoprotein metabolism: New insights & potential consequences for guidelines. Under this headline, we have selected two presentations given at the 86th EAS Congress in Lisbon 2018.

To the SHORT TRACK Lipoprotein metabolism: New insights & potential consequences for guidelines>>

These presentations are open for EAS members only. Register as an EAS Individual member, and the whole ACADEMY is open for you.

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Disturbances in hepatic and lipoprotein metabolism is the hallmark of atherogenic dyslipidaemia.

This presentation was given as a Keynote Lecture by Professor at University of Helsinki Marja-Riitta Taskinen – a long-term and internationally recognized expert in lipoprotein kinetics in health and metabolic disorders including diabetes and dyslipidaemias, as well as the genetics of familial dyslipideamias.
In her Keynote Lecture, Professor Taskinen first discussed that the different components of diabetic dyslipidemia are not isolated abnormalities but closely linked to each other metabolically. Triglyceride-rich lipoproteins (TRLs) are pivotal for the development of ahterogeneic dyslipidaemia, and in type 2 diabetes two key metabolic defects contribute, namely hepatic overproduction and delayed clearance of TRLs, pathways that are highly regulated by apoC-III. She concluded by stating that understanding the metabolic defects in hepatic and lipoprotein metabolism that underpin the development of atherogenic dyslipidaemia in abdominal obesity offers the opportunity for the development of novel therapeutic approached, notably those targeting apoC-III. Ultimately these strategies may result in improvements in the prevention, diagnosis and management of atherogenic dyslipidaemia.


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Is there need to revise goals for lipid lowering?

This presentation was given as a Plenary Lecture by Professor Ulf Landmesser, Chairman of the Department of Cardiology at the Charité – Universitätsmedizin Berlin (CBF). Professor Landmesser has a particular research interest in lipids, vascular biology and coronary disease. First Professor Landmesser outlined the overwhelming evidence that low-density lipoprotein cholesterol (LDL-C) is causal for the development and progression of atherosclerotic cardiovascular disease. Consequently, LDL-C is established as the primary target of lipid-directed therapies for the prevention of cardiovascular events. Current European guidelines recommend an LDL-C goal of less than 1.8 mmol/L (70 mg/dl) or at least 50% reduction if the baseline LDL-C is between 1.8 and 3.5 mmol/L (70-135 mg/dL) in patients at very high cardiovascular risk. With the advent of PCSK9 monoclonal antibody therapy, LDL-C levels well below LDL-C levels seen with statin therapy are attainable. The first of the outcomes studies with these novel agents have shown that substantial LDL-C lowering against a background of intensive statin treatment reduced major adverse cardiovascular events, with no lower LDL-C threshold for cardiovascular benefit. Hence, the evolving evidence base highlights a need for rethinking LDL-C goals, especially in patients at very high risk of recurrent events or with rapidly progressive atherosclerotic cardiovascular disease.

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